Radiation instead of surgery for positive lymph nodes

Hi

I had cancer found in 1 out of 3 lymph nodes.

My treatment was masectomy, chemotherapy, radiotherapy.

I had a choice of either lymph clearance or radiotherapy. I choose radiotherapy.

My reasons were as follows - 

Do not want lympodema caused by clearance, much less likely to get this with radiotherapy.

Statistically they are on a par with each other as far as cancer results are concerned.

Unfortunately even with all the treatment i have had to get rid of my cancer, there is always a risk of it coming back. The cancer teams do their best, but even they can not say if it will or wont come back in the future, because they just have no idea, they can only give you a percentage risk factor.

At present i am doing well so far, no lymphodema, i did not get any issues with radiotherapy either. If you have radiotherapy make sure you use cream several times a day.

I have an expander and radiotherapy has caused some capsular contraction, but i was informed about this. I eill be having reconstructive surgery in the new year taking out my expander and having an implant.

Hope this helps

Thankyou it does and I am so glad you are doing well . I’m not sure I will be getting chemo and I think if it was one out of three rather than one out of two I would feel more confident . I’m a badatient and have been in a state through all of this so far . Also the fact that one node is negative and the other a big positive makes it feel like a gamble . But I guess the main point is that raation kills the cancer . Every other twinge I’m thinking it’s spread .. have a small swollen lymph in my groin that’s got me in a fright x 

Hi. I had a bilateral mastectomy and sentinel nodes removed both sides. 2 out if 3 on one side, and 1 out of 3 on the other cancerous.

My surgeon recommended radiation to the area rather than auxiliary node removal for the same reasons as you...less invasive/less recovery time and less chance of lymphodema. He explained that the reduction in revirrance risk was similar with both treatments.

I decided to take his advice, as was already needing radiotherapy to the breast area and feel like I made the right decision. I felt better when I'd made the decision, as I too had been torn about what was best.

All the best x

Thankyou so much for that and I am so pleased that you are doing well .. do they check your armpit area reg ? I guess my thoughts can’t get my head around that they simply don’t know if it’s spread to more lymph’s so I have to believe that the radiation kills it even if it has is the point … feeling v exposed at mo as no treatment has started so I feel it’s being able to spread while I wait . Are you on hornones too ? 
I keep thinking it might have already spread beyond the axilla .. but your pathway has given me faith in the recommendation for radiotherapy v surgery xx 

The waiting is definitely the worst bit!

I did also have chemotherapy (due to peri-menopausal status).

I get a check with my consultant every 6 months for the next 5 years. Not sure what happens after that, but I know some areas offer annual mri's, so we shall see.

I'm on Anastrozole and Abemaciclib, plus Zoladex implants to put my ovaries to sleep. Early days on those, but doing fine so far xx

I believe I will be on Anastrozole and something else . I’m menopausal so don’t know about the other treatments .. I feel they need to do the radiation immediately or it will spread … if it hasn’t already ..Thankyou so much for your reply itvhas helped because I am frankly in a bad state x 

Hi Becky. I was in a similar situation to you a couple of months ago. Unexpectedly I had 1/2 nodes positive with 5.5mm and extracapsular spread. I was offered the choice of radiation treatment or an axillary clearance. I chose the axillary clearance because I wanted better information for staging; it’s lobular and a bit sneaky; and the positive lymph node had been the non-sentinel node and taken by chance. I had the operation and recovery is slow, but after month i am much better. They found another positive lymph node (again 5mm with EC spread), and only removed 8 in total. Because 2/8 nodes is quite a high ratio I’m now having additional radiotherapy to the armpit, chest wall etc which wasn’t previously planned. So for me the additional surgery has been helpful in getting more accurate information for the treatment needed. But, it’s a hard decision to make and like everyone says the research evidence shows overall  radiotherapy has the same outcomes. 

Thankyou so much it’s interesting to hear that take on it .. I don’t know about extracapular spread so must ask .. are they giving you just chemo and hormone blockers ? I want to know that if I have more nodes that have macros will radiation be adequate to kill everything and how do they know ? Meanwhile because still nothing has been done and it’s weeks now I gear every day that it is spreading .. my nerves are in shreda … me too lobular and also small area of ductal and tubular .. sounds like we are on fairly similar timings .. thankyou so much for your reply xx 

Radiotherapy that was meant to say not chemo … x

And also I am glad to hear you are feeling much better x are you having the radiotherapy now ?